Development and validation of predictive efficacy of enhancement factors for the China-PAR assessment model based on a university employee cohort
10.3760/cma.j.cn115624-20250425-00370
- VernacularTitle:基于高校职工队列的China-PAR评估模型增强因子的构建及预测效能验证
- Author:
Rui WU
1
;
Ling XU
;
Qingfeng HAN
;
Wei ZHAO
Author Information
1. 北京大学第三医院全科医学科，北京 100191
- Publication Type:Journal Article
- Keywords:
Atherosclerosis;
Risk factors;
Risk assessment tools;
Primary prevention
- From:
Chinese Journal of Health Management
2025;19(7):530-535
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the enhancement factors for the China-PAR assessment model based on a university employee cohort and validate its predictive efficacy.Methods:In this retrospective cohort study, 423 employees from a university in Beijing who underwent health checks at Peking University Third Hospital from 2019 to 2022 were enrolled. General demographics, physical examination data, biochemical indicators, and carotid artery ultrasound results were collected. The China-PAR model was used to predict initial atherosclerosis risk in those subjects. Univariate and multivariate analyses of carotid atherosclerosis progression were used to identify enhancement factors for atherosclerosis. Using carotid atherosclerosis progression during follow-up as the endpoint, the ROC curve was employed to compare the predictive efficacy of the China-PAR model for the risk of atherosclerosis before and after the incorporation of the enhancement factors.Results:Among the 423 employees included in the analysis, there were 224 males and 199 females, with a baseline age of (56.2±11.8) years. The proportions of carotid atherosclerosis progression were significantly higher in populations with hyperuricemia, hyperhomocysteinemia, body mass index≥28 kg/m2, waist-to-height ratio>0.5, and low-density lipoprotein cholesterol (LDL-C)≥3.4 mmol/L than those in patients without these health issues (66.0% vs 55.3%, 68.0% vs 56.2%, 72.1% vs 56.6%, 64.5% vs 54.2%, 80.5% vs 56.8%, respectively) (all P<0.05). Hyperhomocysteinemia ( OR=1.833, 95% CI: 1.076-3.123) and LDL-C≥3.4 mmol/L ( OR=3.891, 95% CI: 1.600-9.116) were positively correlated with carotid atherosclerosis progression (all P<0.05) and could be considered as enhancement factors for atherosclerosis. Using carotid atherosclerosis progression during follow-up as the endpoint event, the AUC of the China-PAR model after the incorporation of the enhancement factors was higher than that before incorporation (0.743 vs 0.684) ( P<0.05). The C-statistics of the China-PAR model before and after the incorporation of the enhancement factors was 0.702 and 0.757, respectively, with a net reclassification index of 0.090. Conclusion:Using carotid atherosclerosis progression as the follow-up endpoint, the China-PAR model incorporating hyperhomocysteinemia and LDL-C≥3.4 mmol/L as enhancement factors can better predict the risk of atherosclerosis among university employees.
